Study On The TCM Syndrome Characteristics Of Cerebral Small Vessel Diseas

Objective:This study combined literature and clinical practice to summarize the characteristics of traditional Chinese medicine syndromes in cerebral small vessel disease,providing evidence for the formulation of clinical medication plans.Method:1.Literature research:Retrieve the National Knowledge Infrastructure Database,Chinese Science and Technology Journal Database,and Chinese Academic Journal Database from the establishment to February 1,2023,collect literature related to the syndrome types and elements of cerebral small vessel disease,standardize the data of syndromes and their elements,and adopt statistical methods such as frequency statistical analysis and association rule analysis to explore the distribution patterns of traditional Chinese medicine syndrome types and elements of cerebral small vessel disease to provide theoretical support for later clinical research.2.A cross-sectional study was conducted,and clinical data such as general situation,imaging data,emotional level,cognitive function,and traditional Chinese medicine diagnosis information of patients with cerebral small vessel disease were collected.Statistical methods such as chi square test,non parametric test,T-test,and correlation analysis were used to explore the clinical characteristics and internal connections of related factors in patients with kidney deficiency syndrome and blood stasis syndrome.Result:1.Literature research:(1)Distribution of syndrome types:Including 57 literature,it was found that the traditional Chinese medicine syndrome types of cerebral small vessel disease mainly include blood stasis syndrome and kidney essence deficiency syndrome.Clinical manifestations often involve both deficiency and excess,and primary deficiency is often associated with kidney deficiency,which manifested in kidney essence deficiency,kidney yin deficiency,spleen and kidney deficiency,liver kidney yin deficiency,and heart kidney disharmony.In reality,blood stasis is the main type,and the related syndromes include blood stasis syndrome,qi deficiency and blood stasis syndrome,qi stagnation and blood stasis syndrome,and yin deficiency and blood stasis syndrome.(2)Distribution of syndrome elements:The lesions of cerebral small vessel disease are in the brain,with kidney as the main organ,also involving the liver and spleen.The pathological syndrome elements were mostly qi deficiency,yin deficiency,blood stasis,and phlegm.(3)Syndrome element combination:The main form of syndrome element combination usually involved two syndrome elements,which are commonly seen as "kidney essence deficiency","qi deficiency blood stasis","kidney yin deficiency",and "liver yang hyperactivity".We also summarized the combination of syndrome elements such as "qi deficiency blood deficiency","blood stasis phlegm","yin deficiency yang hyperactivity",and"yin deficiency yang deficiency".2.Clinical research:(1)General situation analysis:Totally 121 patients with cerebrovascular disease were included,most of whom were middle-aged and elderly people.The risk factors included hypertension,diabetes,hyperlipidemia,coronary atherosclerotic heart disease,atrial fibrillation,smoking,alcoholism,etc.(2)The relationship between kidney deficiency syndrome and cerebral small vessel disease:61 cases in the kidney deficiency syndrome group and 60 cases in the non kidney deficiency syndrome group.In terms of general information,there was a statistical difference(P<0.05)between the two groups of patients in terms of age and concomitant hyperlipidemia,while there was no statistically significant difference(P>0.05)between the two groups in terms of gender,education level,smoking history,and drinking history.In terms of neuropsychology,the kidney deficiency syndrome group had higher Montgomery-Asberg Depression Rating Scale and Hamilton Depression Scale scores,while the Mini-mental State Examination score was lower,with a statistically significant difference compared to the non kidney deficiency syndrome group(P<0.05).In terms of imaging,the total score of the Fazekas scale and the overall burden score of cerebrovascular disease in the kidney deficiency syndrome group were slightly higher than those in the non kidney deficiency syndrome group,and there was a statistical difference between the two groups(P<0.01).The score of the Kidney Deficiency Syndrome Scale is positively correlated with the overall load score of cerebrovascular disease(P<0.01).(3)The relationship between blood stasis syndrome and cerebral small vessel disease:73 cases in the blood stasis syndrome group and 48 cases in the non blood stasis syndrome group.In terms of general information,there was no statistically significant difference between the two groups of patients in terms of demographic data and general incidence data(P>0.05).The Montgomery-Asberg Depression Rating Scale and Hamilton Depression Scale scores of the blood stasis syndrome group were higher than those of the non blood stasis syndrome group,and the difference was statistically significant(P<0.01).In terms of imaging,blood stasis syndrome.There were statistical differences(P<0.05)between the group with and without blood stasis syndrome in the perivascular space of the basal ganglia and the overall load score of small vessel disease in the brain.There is a positive correlation between the score of the Blood Stasis Syndrome Scale and the overall burden score of cerebrovascular disease(P<0.05).Conclusion:1.The location of cerebral small vessel disease is the brain,with kidney as the main organ,involving the liver and spleen.The disease is characterized by a mixture of deficiency and excess.The interior showed as the reduction of kidney deficiency and marrow,the loss of nourishment in the brain meridians,and the exterior showed as stagnation of blood stasis and damage to the brain meridians,and the two are mutually causal.2.Kidney deficiency syndrome and blood stasis syndrome are the main syndrome characteristics of cerebral small vessel disease,closely related to infarction,lacunae,perivascular spaces,white matter lesions,and accompanying cognitive impairment,depression,anxiety,etc.In clinical diagnosis and treatment of this disease,emphasized"kidney deficiency" and "blood stasis",with tonifying the kidney by benefiting the brain,promoting blood circulation and unblocking the collaterals as the main methods,with taking into account both interior and exterior,to achieve early diagnosis,intervention,and improve the prognosis of cerebral small vessel disease.